Headaches from running

Headaches from running

 

I recently treated a client with headaches that only came on when running. By working on her neck posture together with specific breathing cues, she is now able to run without triggering neck pain or headaches!

 

Have you ever thought about how you breathe? And how this could be related to neck pain or headaches?

You breathe 12-16 breaths per minute at rest. So that is 17,000 to 23,000 breaths each day! Any bad habits are multiplied manifold.

 

Running out of breath pic

 

 

The diaphragm, a sheet of muscle that contracts to draw air into your lungs, is controlled by nerves from your neck. So poor neck posture affects the efficiency of your main breathing muscle and makes you overuse your neck muscles to try get enough air in. This becomes a cycle of the neck muscles being overly tense with breathing and making it difficult to hold your neck in a good posture….so how do we break this cycle?

Physiotherapy can be immensely helpful. In my client’s case we used joint mobilisation, massage and acupuncture to allow her to relax the tense neck muscles. Then she could work on strengthening the posture muscles of her neck.

 

Becoming aware of your breathing pattern is the first step, try this exercise:

 

Breathing x's sketch

 

 

1. Sit up tall. Place one hand gently on your shoulder, and notice if your shoulder lifts up as you breathe. If it does, you are overusing your neck muscles. See if you can release tension in your neck, shoulders and jaw.

 

2. Next, place your hands on the outside of your ribcage. Can you feel much sideways movement at the ribcage? This is your diaphragm working, as the dome shape of the diaphragm flattens, the ribcage expands laterally. Then, place your hand on your abdomen. Can you feel much rising and falling movement here?

 

If you would like to see if your breathing pattern may be contributing to your neck pain or headaches, contact Alla on 9399 7399.

 

How to Prepare for a 50km Trek

How to Prepare for a 50km Trek

How to Prepare for a 50km Trek

 

You’ve signed up for your first big trek, or perhaps you’re attempting round two. Either way, you’re in the perfect place. Our Physiotherapists, Clare and Alla, completed a fundraising walk for the Fred Hollows Foundation, walking 50km along Sydney’s gorgeous coastline from Coogee to Balmoral. Coastrek raised an amazing $2.5 million to treat preventable blindness around the world. If you are considering signing yourself up for an epic trek, here are their tips:

 

Event Preparation

 

One of their favourite exercises training for Coastrek is for Hip Stability

 

96 adv hip stability

  1. Tie a theraband around your ankles, so that there is some tension in the band when your feet are hip width apart
  2. Take a step sideways, and drop into a slight squat position, then return back. Your kneecap should be centred over the middle of your foot
  3. Alternate sides until you start to feel some fatigue in your glutes

      Progressions

  1. Practice stepping backwards 45 degrees
  2. Dropping down into a split squat position

 

Extra Challenge

  • Repeat the exercise sequence with your heels lifted, balancing on the balls of the feet

 

TIP: Strength in your glutes, quads and calves is key to successfully completing a long trek without injury. It is not just about the hours of pounding the pavement in training alone, but making sure you have strong muscles supporting your joints.

 

If you have difficulty maintaining good alignment of the pelvis, knees and ankles, you may need a physio assessment to outline specific stretches and strengthening exercises for your body

On the Day

 

Strapping tape

Have it with you and know how to use it. Many blister can be prevented with appropriate preventative taping. It can also work incredibly well when a particular muscle is starting to fatigue, to offload it and give some support. Your physio can teach you specific taping strategies for your body.

 

Hydration

Proper hydration is essential in making it to the finish line. Electrolyte mix in you water bottle will keep you going and prevent cramping and dehydration.

 

Trekking poles

Are very useful for when your legs get tired. They allow your Latissimus Dorsi and Triceps muscles to assist in propulsion, taking the pressure off your knees and hips. We were very glad we packed ours for Coastrek.

 

For specific advice on training for your next event, or to assess your alignment and strength, contact PPFC on 9399 7399 to book in to see a Physio

How often do you stop and stretch?

How often do you stop and stretch?

 

The human body was made to move! We are definitely not meant to sit still for hours at a time. However, we are all guilty of sitting at screens for far too long without moving. It can be so easy to become engrossed in a task that we don’t realise how much time has actually passed.

Over time, this can lead to neck and back pain, as well as other injuries. Frequent stretch breaks (every 30-45mins) also ensure you stay more mentally alert and productive.

 

There are hundreds of apps out there to help remind you to move through the day.

 

Some software to consider:

 

Or for those that prefer a physical reminder, a vibrating activity tracker might be the way to go. The wristband will alert you if you are not moving enough, and encourage you to move to reset the inactivity timer.

 

But it can also be as simple as setting a reminder on you PC or phone to get up and move every 30 minutes. Get a glass of water. Walk and chat to a colleague instead of sending an email. Any excuse to move will benefit your body.

 

Exercises to try during your break:
  • Stretching the pectorals improves circulation to the hands and reduces neck and shoulder tension.

 

28a Pectoral release

28b pectoral release

 

 

Place your hand in the doorframe, keeping the elbow bent and pulling your shoulder blade down towards the floor. Slowly rotate your body away from your hand, to create a gentle stretch along the front of the chest. Progress this exercise by moving your hand further up the door to stretch the forearm. Hold for 20 seconds, release, and repeat on the other side.

 

 

 

 

 

 

 

 

 

  • To release tension in the upper back, cross your arms and put one hand on the outside of each knee. Pull back with your shoulder blades as you gently press the knees into your hands. Hold 15seconds, repeat 2-3 times. 16 sitting in chair, shoulderblade stretch
  • Eye exercises: simply looking out into the distance regularly is important in reducing screen related eye strain.

 

 

We all have tendencies to hold tension in different areas, so an individualised repertoire of exercises, determined by your physiotherapist is essential.

For advice on specific exercises you can do regularly at work, speak to your physiotherapist.

 

By Alla Melman, Physiotherapist

Running – Calf Exercises

Prepare to Run with these Calf Exercises

 

Calf tears are arguably the most common running injury. We sit all day, or walk in heels, and the calf muscles get tight. The extra load on the calf in running can lead to a tear. It feels like someone has hit you in the back of the leg, and that’s the end of your running for 4-6 weeks. Faulty foot mechanics can also cause tight calf muscles.

 

Start these simple tips and exercises to run better this season.

 Tips

  1. Start your running slowly and avoid explosive bursts until you are warmed up.
  2. Look up when running hills, and shorten your stride a little.
  3. Increase your running rhythm and don’t overstride to increase your speed.
  4. If you are getting bruised toes or a bunion on your big toe, this is usually a sign that something is wrong. You may be overpronating. We can assist by offering stability exercises and changes to your footwear can correct overpronation. We can also advise if you need to see a Podiatrist.

 

Exercises

Calf Raises114 calf raises2

  1. Start with your knees straight and raise yourself up onto tip toes, maintaining balance and posture. Then, lower your feet back down onto the ground. Don’t grip the floor your toes. Repeat 10-15 times.
  2. Stand on one leg, and repeat this exercises 10-15 times. Repeat on the other leg 10-15 times.
  3. Try this routine with your knees slightly bent.
  4. Once you are confident with these exercises, progress to raising yourself up fast and then lowering back down slowly.115 towel exercise2
  5. Make this exercise more challenging by doing the exercise on the edge of a step or with a rolled up towel under your toes.

 

Stork

  1. Stand in front of a mirror with one foot on the inside of the opposite thigh.78 stork position2
  2. Spread your arms our 90 degrees from your body.
  3. Engage your gluteals to maintain your posture.
  4. Once steady, slowly raise yourself up onto tip toes and then slowly lower back down.
  5. Maintain your balance, and repeat 10-15 times on each leg.

 

 

Stretch

If you have an old chopping board and some large books or bricks, you can make an effective wedge to stretch your calf muscles.Calf stretch - wedge

  1. Angle the wedge down towards a wall. Stand with your back against the wall, and your feet up on the wedge.
  2. Hold this position for 1-3 minutes with your knees straight.
  3. Repeat with your knees bent a little.
  4. Turn your feet in a little to make this stretch a little more challenging.

 

If you’d like to have an assessment of your running biomechanics, improve your stability, speed or strength, please contact us on 02 9399 7399.

 

Alex Sherborne

Physiotherapist

Injury-free Skiing – Exercises

How to Improve your Performance and Have an Injury-free Ski!

 

It took just one hailstorm in Sydney to get me itching to ski this season. Most of us ski just a few times each year, and don’t get ourselves conditioned to ski. Try these easy ski-preparation exercises leading up to your ski holiday!

 

Step 1: Check your Alignment76 sit to stand

Start by preparing how you stand. Draw a mark on the centre of each kneecap and stand in front of a mirror. The mark should be directly above your second toe. Adjust your feet and knees until they are. Do a half squat, keeping the marks above your second toes, then stand back up.

Try lunging forward with one leg, keeping the mark above your second toe, then stand back up and repeat with the other leg.112a standing stability work

Repeat each exercise 30 times, squatting lower and lunging a little further forward each time.

Practice will help you align your legs properly to ski, and get you holding an edge like a pro. If you are having difficulty with these exercises, it may mean you need the canting adjusted on your ski boots.

 

Step 2: How’s your Balance?77b hip extension77a standing knee hug into hip extension

Most skiers put too much weight on the back of the ski. Keeping your weight even from front to back will give you more control and a faster ride. It’s great to practice weight-bearing on a balance board, bosu or duradisc.

Try this exercise on solid ground. Stand on one leg, hugging the other leg into your chest with both hands. Make sure that the centre of your kneecap is over your second toe. Get the weight on your toes the same as the weight on your heels. Once you feel steady, extend the leg and your arms behind you, keeping the weight even on toes and heels, then return to your starting position.

Repeat 10 times on each leg.79 advanced pendulum exercise

Progress to the Arabesque position, extending the leg straight behind you, with one arm extended in front. Then return to the starting position.

 

 

Step 3: Strengthening Glutes & Quads

Gluteus Medius

No sport uses Gluteus Medius as much as skiing. Good control of the hips includes having strong glute meds, and this is essential for your turns.04081502

Stand side on to a wall, with your hands on your hips. Lift the knee closest to the wall. Pushing this knee into the wall will make the glutes contract on your standing leg. Maintain your alignment and balance throughout this exercise.

Hold for 10 seconds and repeat 8-10 times each side.

To progress this exercise further, try turning out the foot you are standing on, against the resistance of the floor.

Quadriceps113 quads step strengthening

Your quads are the workhorses of your skiing. You need strength and endurance in these muscles.

Stand with one leg on a step and the step the other down towards the floor in front of you. Stop before your foot actually hits the floor and return to your starting position.

Repeat 10-15 times and do 3 sets on each leg. Maintain your alignment and balance. Move to a higher step and add weights to progress this exercise when you’re ready.

 

 

Step 4: Endurance

The fitter you are, the longer you will enjoy your day on the slopes. That chair ride up only lets you recover so much!

Running, skipping, cycling or using an elliptical trainer as often as you can – at least every second day – is the easiest way to improve your baseline fitness and endurance.

If you have the right space and equipment, in-line skating uses many of the same muscles and techniques as skiing. Jumping exercises get the heart pumpin04081501g and help prepare for those moguls. Find a sturdy, low box that you can stand on, and give yourself lots of room. (Step aerobic steps are great for this.)

Start by standing feet together on the box, and stepping one leg sideways until it touches the ground, then return to both feet together on the box. Step to the other side. Repeat 30 times to each side, and keep your alignment and balance as you go.

Once you’ve mastered this exercise, keep your feet together and jump both feet to the floor on one side, then back onto the box, then both feet to the other side. Repeat 30 times on each side.

Increase the height of the box, and try jumping forward and back when you can.

 

 

Step 5: Improve your Flexibility

Flexibility is particularly important when you are doing tricks or racing, and it is vital that you stretch any muscle that feels tight before andCalf stretch - wedge after your day on the slopes, especially as fatigue and the cold will make your muscles tighten up.

A good stretch for your calf muscles can be achieved by using a low wedge (an old cutting board against a brick or similar will do the job.) Angle the wedge down towards a wall, and stand with your back against the wall. Hold this position for 1-3 minutes with your legs straight (gastrocnemius), and then repeat with your legs a little bent to reach you61 hip flexor stretchr deeper calf muscles (soleus).

 

Your hip flexors will also need a good stretch after skiing. On your knees, lunge on leg forward with your pelvis tucked under, and then stretch the arm on that side over. Hold for 20 seconds, and repeat on both sides.

A simple quad stretch will also assist your muscle recovery after skiing. You can use a wall or table to support you. Stand up tall on one leg.

107 standing quads stretch

Bend the other leg and reach the foot up behind you. Hold onto your foot and try to keep your knees together. Hold for 20 seconds, and repeat on both sides.

 

 

If you follow these 5 guidelines, your performance will improve on the slopes this season, and you are much less likely to suffer injuries. Prevention is always better than cure! If you have any trouble with these exercises, or would like to improve your performance further, speak to your Physiotherapist.

 

At PPFC, our resident Skiing Physio is Alex Sherborne. Call to make an appointment with him on 02 9399 7399.

Why do I keep rolling my ankle?

Ankle sprains: Why do I keep rolling my ankle? Exercises to stop it happening!

Clare_Alla_balance

There are position receptors, “proprioceptors” located in your joints, ligaments and tendons. They sense where your body is positioned in space, sending this info to your brain.

With any injury, such as a rolled ankle, there is likely to be altered proprioception. Has your ankle ever felt vulnerable on uneven ground or with unexpected movements? Poor proprioception is why its common to suffer recurrent ankle sprains – the ankle stability muscles don’t kick in when your ankle starts to roll.

By using unstable surfaces, we can retrain the stability muscles to function as they did pre-injury – or even better! That’s why it is excellent for you to practice walking on uneven surfaces after an injury.

 

Your challenge to test your stability:

(Caution: stand near a wall for safety when first trying this)

• Can you stand on one leg with your eyes closed? Try keeping your balance there for more than 10 seconds.

• Was this too easy? Stand on a rolled up towel to challenge your balance. Eventually you can add multitasking like throwing and catching a ball to this exercise.

 

In our gym, we use exercises on foam balance beams and the Bosu to retrain proprioception. A real challenge is walking on the beam with your eyes closed. Most of us are heavily reliant on vision for body awareness, and taking this away really works your other positional senses! The goal is to retrain your balance and co-ordination, as this will reduce your risk of re-injury.

 

For more tips on how to stop injury recurring, call 93997399 and request a consultation with Alla.

 

By Alla Melman, Physiotherapist

Challenge your balance!

Core stability exercises: poor balance is often an indicator of poor core stability

Your posture muscles are meant to kick in to keep you upright when your balance is challenged. They are the ones that you can feel switch on when keeping your balance on a moving bus. But you don’t just need your core when the bus driver slams on the brakes!

 

Even when you are sitting or standing ‘still’, muscles are switching on and off all the time to keep you balanced. Even having tight and sore neck and shoulders can be enough for your core muscles to be a bit ‘sleepy’. When the core muscles are slow to turn on, or don’t turn on at all, there is increased risk of back pain and other injuries.

 

If you do have back pain, you need to retrain smooth coordinated movement of the core, a balance between stability and mobility. It is incorrect to rigidly brace the spine; you should be able to breathe freely.

 

Helpful tips: How to stop your posture and core muscles fatiguing when sitting

  • Sit tall, and initiate movement as though you were about to stand up
  • Flutter: relax your arm down by your side palm facing forward. Imagine you are shaking drops of water off your hand, feel the movement all the way up into your shoulder. Do each hand separately. Do you feel any difference side to side? If one side feels harder to engage your core, this is usually your weaker side.

Do this exercise every few hours to remind you to engage your stability muscles when seated.

 

d4

 

 

 

You can also try sitting on a gym ball and lift one foot off the floor. Can you keep your balance? Can you add a flutter with your arm and still maintain your balance?

 

 

 

 

 

 

 In our physio gym we use a variety of equipment to challenge your balance and make core stability exercises fun! Allas blog

  • soft balance beams
  • Bosu
  • gym balls
  • dura discs
  • wobble boards

Anything that challenges your balance is a great way to wake up your ‘core stability’ muscles.

 

 

 

For more information on how you can improve your balance and core stability, call 93997399 and request a consultation with Alla.

 

 

By Alla Melman, Physiotherapist

Understanding Persistent Pain & What You Can Do To Recover

Understanding Persistent Pain & What You Can Do To Recover!neck pain

 

The first thing to understand about persistent pain is that the amount of pain you experience does not necessarily relate to tissue damage. There are people who have severe joint degeneration on x-ray and don’t have pain, and others that have clear x-rays and lots of pain. Pain is a normal response to your brain perceiving something as a threat, this is the body’s way of protecting itself, and in the short term it works well.

 

The body initially responds to an injury with inflammation, which promotes healing. When pain persists despite tissue healing, it is because the nervous system – nerves, spinal cord and brain have become sensitised.

 

It works like this: there are nociceptors, lets call them ‘danger sensors’ all over the body. With enough stimulation, they send signals up to the spinal cord. When stimulation reaches a critical level, the message is sent on to the brain. The role of the brain is to assess these messages, and if the brain concludes that you are in danger and need to take action, it will produce the experience of pain. So while the pain is very much real, it is an output of the brain, not just a sensation in the body tissues.

 

With persistent pain, your nervous system changes. You develop more of some types of danger sensors in the nerves and spinal cord, and their alarm threshold is lowered. It is kind of like a car alarm that goes off when a leaf blows over it; the nervous system is in a state of hyper-vigilance, always on the lookout for threat. The brain becomes really good at producing the experience of pain, through repeated experience. So over time, it takes less and less to trigger your pain, even thinking about bending or lifting can be enough to feel pain. This sets you up in a downward spiral, the less activity you do to avoid pain, the more deconditioned and hypersensitive your tissues get, and the more pain you have.

 

There is a strong link between feeling depressed, stressed or angry and persistent pain. Stress affects your physiology and further sensitises the nervous system. Your attitudes and beliefs make a huge contribution to your experience of pain. We consistently see that people with overly negative or unhelpful thoughts have much more difficulty recovering from their injuries. However, learning positive ways of coping, such as pacing yourself effectively can significantly reduce your disability. Upgrading your activity in a slow and steady manner can begin to desensitise the nervous system, and hence reduce or even eliminate your experience of pain.

 

One of the ways we facilitate this here at Physio Posture Fitness, is through Physiotherapy Gym Sessions (PGS), allowing a supervised, graded return to activity in a focussed individualised manner. Whilst the exercises precisely target weak or tight muscles, they are also designed to reduce the sensitivity of your nervous system to allow you to get back to doing what you love to do.

 

Tips for tackling persistent pain:

Your brain is amazing, capable of rewiring itself to recover from persistent pain. Try these ‘brain’ exercises to change neural connections in your brain straight away.

  • Virtual Reality: Close your eyes and imagine yourself doing an activity that you love pain free: running, wrestling with the kids, gardening. Play the positive video in your head over and over.
  •  Remember to keep exercise fun – laughter really is the best medicine! Put on your favourite music & let yourself dance. Move without fear.

 

 

 

Now try these stretches:

1)      Neural Glides are an effective way of mobilising the nervous system and encouraging freedom of movement. They are a way of desensitising neural pathways throughout the day. A mobile nervous system is a healthy nervous system.

 

 

1 Nerve Mobility Palm Upward_1

 

Stop sign: put your hand out in front of you as if directing traffic to a stop, only straighten your elbow to a comfortable range. Try this progressively further out to the side until you can do it comfortably side on to your trunk.

 

 

 

 

 

 

 

 

2)      Try approaching a movement in a novel way to get under the radar of a sensitised nervous system:

–  Instead of turning your head, keep it still and swivel your trunk around in an office chair.

–  Try moving your eyes side to side whilst sitting tall and holding the head still to wake up your postural muscles and give your eyes a break from the screen

 

 

By: Alla Melman, Physiotherapist

 

Exercises extract from New Bodyworks book by Francine St.George.

Upper Body Nerves & Posture

Needing some fun exercises to ease unwanted neck and shoulder aches and pains?

Crazy elbow stretch

by Francine St George, 28/11/13

Our body does not like being in a sedentary postion for hours on end! Postural muscles fatigue and muscles that should be used for movement take over and tighten up.  This in turn can cause tension on the nerves that run from our neck to our arms.  Try to take regular breaks every hour or so and have fun with the following exercises!

 

How to do nerve exercises correctly

We talk about gently winding up or tensioning up a nerve as the starting point for doing a nerve exercise. This means we position the body so the nerve is being slightly tensioned as it emerges from the spine and runs into a more distal area. We can then move either the limb, the back or the neck and this will begin to loosen the nerve. It is critical that you do not overstretch or force a nerve mobility exercise as this will cause pain. It is also important that if you feel pins and needles, or latent pain,  then you need to ease back, as you are definitely overdoing it.  In this case, consult your physiotherapist to find out how to do your nerve mobility work correctly.

 

4 Relaxing the neck and shoulder_1

1. First lets relax the upper neck and shoulders…

Place your left hand onto your right shoulder. Tighten your right shoulder muscle by shrugging your shoulder. Now relax this muscle by altering the position of your right shoulder joint so that you can feel with your left hand that your right shoulder muscle is as relaxed as it can be. Try positioning your shoulder back and downwards, and then relaxing and softening your posture without slumping and this will usually help this muscle relax. Once you have learnt how to do this with your hand on your shoulder you can then do this whenever you feel yourself getting a little tense. Be sure to repeat this exercise on the opposite side – using the right hand on the left shoulder.

1 Nerve Mobility Palm Upward_1
2. Nerve mobility; palm facing away and fingers up

While sitting in a chair, take your hand out to the side of your body with your fingers facing upwards. Imagine there is a wall there and you are gently bending your elbow and almost straightening it while moving your hand towards and away from this imaginary wall. Keep your hand at about waistline level and then start to move your arm backwards slightly behind your body. If you feel tightness in your hand, this means you have tension in the nerves running from your neck into your forearms.

 

 

 

 

2 Nerve Mobility Fingers Down_1
3. Nerve mobility; fingers facing down

Now, turn your fingers downwards facing the ground with your palm still facing away from your body. Start with the elbow bent and then try to straighten it. Do this very gently with small oscillating movements. Be sure you expand the chest and pull the shoulders back and downwards for the exercise to be more effective.

 

 

56 crazy elbow stretch_1

4. Crazy elbow stretching

This exercise is for tensioning the ulnar nerve which traverses the medial side of the elbow. Have fun with it! Make a circle with the tips of the thumbs and index fingers. Raise the arms and roll the other fingers towards you. Place the circles formed by the thumb and index fingers around the eyes and spread the fingers lengthways down the side of the face. Gently depress the shoulders and pull the shoulder blades together to achieve an effective stretch. Hold for 10–15 seconds. Great stretch if you are working at a computer and don’t mind your colleagues’ comments!

 

 

Extract New Bodyworks, Francine St George 2013

 

Gluteals & Piriformis Stretch

Sacro-Iliac Joint Pain

pelvis_sijby Penny Elliott, Physiotherapist

 

If you have back pain that is not in the middle of the lower back but is slightly to one side, it may be a problem with the sacroiliac joint (SIJ). The usual reason for an ache in this joint is poor alignment because of muscle imbalance. Tight hip flexors and adductors and weak core stability or pelvic floor muscles are usually associated with sacroiliac joint pain. Pregnancy can also cause problems in this joint because of the extra weight it is bearing. In this case a sacroiliac belt can give a lot of relief and stabilise the joint more effectively.

 

The starting point is to ease the pain with stretching of gluteus maximus, medius, minimus and the piriformis, and then commence stability work. If you feel as though your pelvis ‘goes out’ all the time, or you have pain referral through your gluteals, this stretch can help you stop the pain cycle.

 

If you have knee pain however, please do not do this stretch, but consult with a physiotherapist.

 

Sacroiliac stretch

Extract New Bodyworks 2013

 

Sacro-Iliac Joint, Gluteals & Piriformis Stretch

 

Place your foot on a bench or up on a high chair. Let the knee drop out a little.

Now bend your supporting leg to take any stress of the lower back and then lean the trunk forward onto the hands until you feel a stretch in the hip and buttock of the leg that’s on the bench.

Hold for about 10 -15 seconds and then repeat on each side for a few repetitions.